Dihydropteridine reductase deficiency: levodopa's long-term effectiveness without dyskinesia.
case_report · Level V
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Abstract
We report an adult patient lacking endogenous synthesis of monoamines (dopamine, serotonin, and catecholamines) due to a severe dihydropteridine reductase (DHPR) deficiency. With levodopa and 5-hydroxytryptophan (5HTP) supplementation, the patient exhibited moderate mental retardation, acute episodes of parkinsonism, and episodes of depression. Despite the use of levodopa from age 3 months, he exhibited no dyskinesia or dopaminergic cell loss as suggested by normal PET imaging of the dopamine transporter.
Medical subject headings
- 5-Hydroxytryptophan
- Dyskinesia, Drug-Induced
- Levodopa
- Phenylketonurias